纤维支气管镜检查联合肿瘤标志物检测对肺癌的诊断价值探讨  

Diagnosis value of fiberoptic bronchoscopy examination combined with tumor marker assays in sputum analysis of patients with lung cancer

作　　者：钟燕[1] 刘大鹰[1] 陈锦平[1] 李乃庆 周锦钢[1] 陈亦平[1] 谭宏春 

机构地区：[1]柳州市柳铁中心医院呼吸科,广西柳州545007

出　　处：《临床荟萃》2012年第22期1950-1952,共3页Clinical Focus

摘　　要：目的分析研究纤维支气管镜(fiberobronchoscopy,FB)检查联合肿瘤标志物(tumor marker,TM)检测对肺癌的诊断价值。方法给予44例肺癌患者(A组)、42例肺部良性病变患者(B组)纤维支气管镜检查,同时利用化学发光免疫分析法对患者痰液中的肿瘤标志物:癌胚抗原(carcino-embryonic antigen,CEA)、糖类抗原(carbohydrate antigen 125,CA125)、细胞角蛋白19片段21-1(cytokeratin 19fragments 21-1,CYFRA21-1)进行检测。结果 A组患者的CEA、CA125、CYFRA21-1的阳性率分别为45.4%、45.4%、54.5%;B组分别为11.9%、14.3%、16.7%,A组患者的各项痰液TM指标阳性率均显著高于B组(P<0.05)。且CYFRA21-1的阳性诊断率高于CEA、CA125。44例A组患者FB确诊25例,敏感度为56.8%,特异度为100.0%,准确率为77.9%。FB联合TM检查的敏感度为94.6%,特异度为87.3%,准确率为91.2%,均显著高于单一检查方式(P<0.05)。结论 FB联合TM检查诊断肺癌的临床价值明确,能够有效地提高其诊断准确率。Objective To study the diagnosis value of fiberoptic bronchoscopy（FB）examination combined with tumor marker（TM） assays in sputum analysis of patients with lung cancer.Methods By FB examinations and the method of chemiluminescent enzyme immunoassay for the assay of TM in sputum,including carcinoembryonic antigen（CEA）,cytokeratin 19 fragment antigen 21-1（CYFRA21-1）,cancer antigen（CA）,44 cases with lung cancer（group A）and 42 cases with benign lung disease（group B） were studied.Results Among group A,the positive percentage of CEA,CA125 and CYFRA21-1 in sputum analysis were 45.4%,45.4% and 54.5%,respectively,which were significantly higher than those of group B,respectively as 11.9%,14.3% and 16.7%（P〈0.05）.The positive diagnosis percentage of CYFRA21-1 was higher than that of CEA or CA125.The sensibility,specificity and accuracy of FB examination in group A were 56.8%,100.0% and 77.9%,respectively.The sensibility,specificity and accuracy of FB examination combined with TM assays were 94.6%,87.3% and 91.2%,respectively,all were significantly higher than either FB examination or TM assays.Conclusion FB examination combined with TM assays in sputum analysis can improve sensitivity and accurate value in diagnosis of lung cancer.

关 键 词：肺肿瘤 支气管镜检查 痰 肿瘤标志物 诊断 

分 类 号：R734.2[医药卫生—肿瘤]